Marie Herr1,2, Jean-Marie Robine3, Juliette Pinot1,2, Jean-Jacques Arvieu4, Joël Ankri1,2. 1. INSERM, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, U1168, Villejuif, France. 2. UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France. 3. INSERM U988 et U1198, EPHE, Paris & Montpellier, France. 4. AG2R La Mondiale, Direction des Etudes, Prévoyance Individuelle et IARD, Paris, France.
Abstract
PURPOSE: To assess the prevalence of polypharmacy and frailty, to examine their association, and to establish their independent and combined effects on mortality in a sample of French old people. METHODS: This is a cross-sectional population study of people aged 70 years and over. A total of 2350 respondents were interviewed at home in 2008-2010. Frailty was defined as impairment in three domains or more among nutrition, energy, physical activity, strength, and mobility, in the absence of difficulties in basic activities of daily living. Mortality data were documented after a mean follow-up period of 2.6 years. RESULTS: Mean age of the population was 83.3 +/- 7.5 years, with 59.4% of women. Prevalence of frailty was 17.0%. Polypharmacy (5-9 drugs) was reported in 53.6% of the population, and excessive polypharmacy (10 drugs or more) in 13.8%. After adjustment for socio-demographic and health variables, polypharmacy and excessive polypharmacy were associated with frailty with odds ratio 1.77 [1.20-2.61] and 4.47 [2.37-8.42], respectively. Frailty (hazard ratio [HR] 2.56 [1.63-4.04]) and excessive polypharmacy (HR 1.83 [1.28-2.62]) were independent predictors of mortality. Compared with non-frail people without polypharmacy, frail people with excessive polypharmacy were six times more likely to die during the follow-up period (HR 6.30 [3.09-12.84]). CONCLUSION: By showing the independent and combined effects of polypharmacy and frailty on mortality risk, this study should reinforce the awareness of clinicians with regard to these factors, rather prevalent in old people.
PURPOSE: To assess the prevalence of polypharmacy and frailty, to examine their association, and to establish their independent and combined effects on mortality in a sample of French old people. METHODS: This is a cross-sectional population study of people aged 70 years and over. A total of 2350 respondents were interviewed at home in 2008-2010. Frailty was defined as impairment in three domains or more among nutrition, energy, physical activity, strength, and mobility, in the absence of difficulties in basic activities of daily living. Mortality data were documented after a mean follow-up period of 2.6 years. RESULTS: Mean age of the population was 83.3 +/- 7.5 years, with 59.4% of women. Prevalence of frailty was 17.0%. Polypharmacy (5-9 drugs) was reported in 53.6% of the population, and excessive polypharmacy (10 drugs or more) in 13.8%. After adjustment for socio-demographic and health variables, polypharmacy and excessive polypharmacy were associated with frailty with odds ratio 1.77 [1.20-2.61] and 4.47 [2.37-8.42], respectively. Frailty (hazard ratio [HR] 2.56 [1.63-4.04]) and excessive polypharmacy (HR 1.83 [1.28-2.62]) were independent predictors of mortality. Compared with non-frail people without polypharmacy, frail people with excessive polypharmacy were six times more likely to die during the follow-up period (HR 6.30 [3.09-12.84]). CONCLUSION: By showing the independent and combined effects of polypharmacy and frailty on mortality risk, this study should reinforce the awareness of clinicians with regard to these factors, rather prevalent in old people.
Authors: Jessica E Lockery; Michael E Ernst; Jonathan C Broder; Suzanne G Orchard; Anne Murray; Mark R Nelson; Nigel P Stocks; Rory Wolfe; Christopher M Reid; Danny Liew; Robyn L Woods Journal: Pharmacotherapy Date: 2020-10 Impact factor: 4.705
Authors: M Gutiérrez-Valencia; M Izquierdo; M Cesari; Á Casas-Herrero; M Inzitari; N Martínez-Velilla Journal: Br J Clin Pharmacol Date: 2018-05-03 Impact factor: 4.335
Authors: L Gené Huguet; M Navarro González; B Kostov; M Ortega Carmona; C Colungo Francia; M Carpallo Nieto; A Hervás Docón; R Vilarrasa Sauquet; R García Prado; A Sisó-Almirall Journal: J Nutr Health Aging Date: 2018 Impact factor: 4.075
Authors: Hugo A J M de Wit; Bjorn Winkens; Carlota Mestres Gonzalvo; Kim P G M Hurkens; Wubbo J Mulder; Rob Janknegt; Frans R Verhey; Paul-Hugo M van der Kuy; Jos M G A Schols Journal: Int J Clin Pharm Date: 2016-05-13